> what if the "Yes, of course, spend the $50K!"
> results in each of us paying $100 more
> every month

Well, would it? These aren't voodoo séance whispers, they're actuarial calculations. So let's do one!

According to Wikipedia, a globally-respected source for this kind of data, the incidence of age-standardized death in the United States from pancreatic cancer was 7 per 100,000 inhabitants in 2004.

So, therefore, we can see through simple arithmetic that... Christ, I'm flying on fumes.

You gotta hunnert thousand people. Sebben of them get Pan-C. (Unlikely!) All of them will benefit from the $50K treatment for five months. (Crazy unlikely!) $350K expense / 100K insureds means everybody's down 3 and ½ smackeroos per annum… A deuce and three quarters each and every fourth of July, or about a penny a day per policyholder.

(That's with no cost for diagnosis or treatment miscellany or paperwork or administration. THAT would be a great planet, right?)

I was going to say we save the celebrities and let the poor rot, but then I saw what happened when Chuck Norris succumbed to a lifetime of kicks to the head.

http://news.yahoo.com/blogs/ticket/chuck-norris-endorses-newt-gingrich-224223391.html

Kicked in the head. With a boot. An iron boot!

> Chuck Norris succumbed to a lifetime of
> kicks to the head

How dare you, Gog.

> but then there are all the others

Yeah, but every time you ask people to get serious about mortality on this blog, you get either cartoon bravado or cartoon fatalism. We aren't as eager to know the prices of these things as we pretend to be, especially when we're not paying for them.

Barry asked for another $1.2 trillion, so everything will be fine.

A favorite book has this passage:

[T]he series finale of the CBS show Walker, Texas Ranger, a mainstream program whose target audience was senior citizens, depicted twenty police officers murdered.

Y'know, that's a crazyshit amount of violence. People should be able to watch what they want on TV. But being the kind of person who got rich by slamming such hideous imagery into the public consciousness shouldn't make us turn to you for guidance in politics.

This is where a free-market in health insurance would do far better than any governmental regulation. Is it worth it for you to have insurance that pays for this kind of care? Pay for it. If not, don't.

Government programs should only exist for people who either cannot afford any insurance, or who are uninsurable due to existing conditions. In both cases, available care should be spelled out black-on-white, and restricted to the absolute minimum. It is essential that government care be worse than the cheapest private care, otherwise people will avoid purchasing health insurance even if they can afford it.

Note also that this must be cold-bloodedly defined, without looking at individual cases. I remember a case in New Hampshire some years ago: a cute little girl was going to die if she didn't get a liver transplant, and the parents had no health insurance. The state courageously said "no". This hit the newspapers in neighboring socialist Massachusetts, and New Hampshire caved to the public outrage. All because this particular individual was a cute child. This is not how governmental decision-making should work.

> Government programs should only exist for people
> who either cannot afford any insurance, or who
> are uninsurable due to existing conditions.

Well, I'm afraid that if you're willing to go that far, the damage is already done, for two reasons.

At the most basic level, health care is an asset that everyone wants, and most people will survive without the very best. (See also cars, scuba trips, sex with supermodels, and so forth.) Modern folks seem to think that everyone deserves the best of this particular asset, but modern folks don't want to think that people who provide it should be paid as much as a free market would charge.... So that's a problem. Nobody EVER talks about this solving this by earning more money to pay for the care. The whole country, from the smartest and most powerful people to the dimmest and most desperate, is still looking for a magical portal to a Star Trek parallel universe where everything is free-free-free, or at least cheaper-cheaper-cheaper. The poor are supposed to get the best without earning it: Fat chance.

Another great confusion comes from describing the problem as "insurance". Given all the compassion conveyed by your language, it appears that you sincerely want people who are down on their luck to be made healthy again... That's noble. But casting it into the realm of insurance, and all the administration and policy and competition and LAW that comes with insurance, feels like a terrible diminution of that compassionate impulse. A lot of the really impoverished people who need health care aren't up to managing a checking account: Why do we have to pretend they're shuffling their own assets in preparation for a rainy day?

> It is essential that government care be worse
> than the cheapest private care, otherwise people
> will avoid purchasing health insurance even if
> they can afford it.

That's nobly cruel, but if you try it out verbally in a room full of moderates, let us know how it works out....

Amy, I wouldn't take the bevacizumab treatment. I'd cringe at having 100K spent on me to extend my life several months. I really need to get me a living will, so that I won't have such stupidity perpetrated on my behalf.

By the way, this stuff shows what a racket the public-private health insurance scheme is. Where else in our economy do you have such a mix of public- and private-sector socialism. Medicare, Medicaid, S-CHIP and tax bennies for private insurance. Meanwhile, the health insurance hides (and probably drives) all these skyrocketing medical costs and a lack of cost-saving innovations in medical care.

@Crid: I don't think my views are such a contradiction. I am convinced that the biggest reason that health-care costs are so high is because of the horrible mix of government regulation and free-market, giving us the worst aspects of each.

With genuine free-market insurance - little if any government regulation beyond enforcing agreed-to contracts - health-care costs for the average person would plummet. This would already be a huge plus.

For those people who, as you say, can't balance their checkbooks - you're right, I am (just barely) liberal enough to think that society should ensure a basic level of health care. However, this level should be *very* basic. If you have the brains god gave a turnip, and a job, you should *want* to buy your own insurance.

This is roughly where the country was decades ago. You didn't let people die on the street, or at least not too often. But showing up in the emergency room with unidentifiable pain, in hopes of landing some free narcotics, would have gotten you thrown out on your ass.

The problem is: naive people want a perfect world. A few patients got thrown out of emergency rooms for faking, but they were genuinely ill - so we got EMTALA. Now the emergency rooms are required to take everyone seriously, which is a license for abuse and makes the costs skyrocket for everyone. The same thing has happened in all other areas of health care. Somehow government regulation is supposed to make the bad things stop happening...

Just to play devil's advocate for a second, does this treatment always have to cost $50K? R&D costs are real, but fixed, and once they are recouped the cost (I am assuming this is a drug, not a team of nurses giving Swedish massage every hour) should go down.

There is always somebody with the money who wants it bad enough to pay (You can't ask Patrick Swayze or Steve Jobs any more, but I'm guessing they'd have forked over the cash for 6 months more.) Those of us without the $50K eventually benefit.

No government required.

This is where a free-market in health insurance would do far better than any governmental regulation. Is it worth it for you to have insurance that pays for this kind of care? Pay for it. If not, don't.

Government programs should only exist for people who either cannot afford any insurance, or who are uninsurable due to existing conditions. In both cases, available care should be spelled out black-on-white, and restricted to the absolute minimum. It is essential that government care be worse than the cheapest private care, otherwise people will avoid purchasing health insurance even if they can afford it.

a_random_guy, I am with you here.

"Where Do We Draw The Line?"

1) Whaddya mean 'we', paleface?

2) Are you paying with your money, or someone else's?

3) If someone else's, did they give it to you of their own free will?

It's ridiculous that we spend so much leeping a person alive while not providing basic maintainance like mammograms and colonoscopies. My Mom has been catatonic with Alzheimers now three years, at a personal cost of almost $100k a year.

more fun and factoids...

http://finance.yahoo.com/news/5-americans-made-50-u-195410001.html

Fortunately for all of us these difficult decisions are going to be made for us by Washington DC. Which will carefully consult its political correctness chart to determine who gets what treatment.
Breast Cancer - Female top of list
Pancreatic Cancer - Anybody middle of the list
Prostate Cancer - Male bottom of the list

Just wait till the government actuaries get their hands on the number of ultrasounds and other tests that are routinely done to women over 35 who get pregnant.

When the government refuses to cover treatment and offers only abortion as an option, you'll see heads explode.

Human life is priceless!!11! If we need to spend the entire national GDP for a year on saving one life, it is worth it!!!!111!1!one1

> If you have the brains god gave a turnip, and a
> job, you should *want* to buy your own insurance.

Agreed, agreed. I'm gonna steal that line.

> The problem is: naive people want a
> perfect world.

Yes, and worse: Naive people want to insist that third parties be more compassionate; They want the rest of society to put up the money for free health care for the poor (and others... Many, many others.) They want to get to Heaven on someone else's dime. I hate that.

> Just to play devil's advocate for a second, does
> this treatment always have to cost $50K? R&D
> costs are real, but fixed, and once they are
> recouped the cost… should go down

Naw. Even in a theoretical example, I want the people who bring us these miracles to be well paid... That's how we get miracles.

See what I mean?

"(That's with no cost for diagnosis or treatment miscellany or paperwork or administration. THAT would be a great planet, right?)"

Glad you agree with me!

And all, please note: "insurance" does not mean the same thing for "health care" (in quotes because nobody can quite agree what that is) as it does in the sutomobile business.

Everyone suffers a loss of health. Not everybody crashes a car. If this distinction is not being pointed out to you, you are being subtly deceived, but deceived nonetheless!

I shouldn't have said "Naw" that way. Apologies.

MarkD is perfectly correct in all respects.

Copyright, trademark and patent should serve the needs of ALL people by encourage performance, and helpful innovations. The point is not just to make creators rich, the point is to have creations that benefit everyone, and do so inexpensively.

But thinking about health care causes the man on the street to believe something wonderful should just appear in front of us for no reason, with no effort or sacrifice. It's that Star Trek thing mentioned earlier.

So when someone says "after costs are recouped, the costs should go down", I feel compelled to add "But not immediately!" Capitalism has given us more wealth and comfort than any other system, because it acknowledges that people, both the best and the worst people, do their best work when pursuing their own interests.

There are limits. Across the globe, there were about 3 million AIDS deaths in 2001.

But in the United States, there were 5 deaths from anthrax, so our government demanded cheaper drugs, and got them.

And then....

Random Guy - Crid wasn't disagreeing with you, he was just pointing out that government-funded programs don't work that way.

American health care is the mess it is because legislators figured out they could get votes by giving out lollipops.

Government is always "expanding coverage" of everything it does.

So talk about "minimum government health coverage" is like feeding stray kittens...

The only way to avoid the inevitable mission creep is to bring private charity in to support the stupid/indigent/uninsurable... government involvement would have to stop at matching grants or tax breaks for private medical charities.

But hey - this thread is already pretty Dickensian...

Government programs should only exist for people who either cannot afford any insurance, or who are uninsurable due to existing conditions.

What constitutes an "existing" condition?

Put enough conditions on that list and the government ends up providing healthcare for everyone anyway.

In a truly free market for health insurance, someone will come up with a way to provide health insurance and healthcare to even those folks at a profit ... and do it at a reasonable price.

With genuine free-market insurance - little if any government regulation beyond enforcing agreed-to contracts - health-care costs for the average person would plummet. This would already be a huge plus.

You're forgetting to factor in the increased costs due to the medical malpractice lawsuit industry.

People don't understand biology and medicine, so juries are willing to award ridiculous settlements to patients hurt by careless doctors and greedy drug companies.

The jury figures, "Hey, the drug company reported record profits, right? They should share them. It's only fair." Well, skippy, the drug companies put a big chunk of those profits into researching the next generation of miracle drugs.

John Edwards got rich exploiting this with mostly-spurious medical malpractice lawsuits ... and he only got 40% of the take. The cost to the medial profession was more than twice what he walked away with.

It's a positive reflection on the medical profession that Edwards even has a heart surgery team working to save his life instead of smugly carping that he's getting what he deserves. Think he appreciates the irony?

Capitalism has given us more wealth and comfort than any other system, because it acknowledges that people, both the best and the worst people, do their best work when pursuing their own interests.

Wish more politicians (and voters) understood that.

> Government is always "expanding coverage"
> of everything it does.

Tweet of the year*: Also, healthcare.

* Only mid-January, but this guy is a master.

>>I saw what happened when Chuck Norris succumbed to a lifetime of kicks to the head.

Kicked in the head. With a boot. An iron boot!

Maybe it is simply due to Chuck Norris picking a bad week to stop sniffing glue.....

Fun graph.

I challenge all the readers here to decide what they would do IF they had pancreatic cancer?

Would they just DIE to save everyone else some money or would they do anything they could to live.

I bet they pick life.

What is more, the ONLY reason some cancers are curable is because we pushed to find ways to cure them.

Sad so many people want to throw others under the bus (as long as it's not them...)

Paul.

How much of other people's money, their time, do you think YOU are ENTITLED to?

Because that's what your "do anything they could" means right now.

Given current treatment options I'd spend my money on hookers and hallucingenics and have some FUN with the last few months of my life